Provider Demographics
NPI:1801343009
Name:BORRERO, ABBILIZ (MSW)
Entity type:Individual
Prefix:
First Name:ABBILIZ
Middle Name:
Last Name:BORRERO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-0550
Mailing Address - Country:US
Mailing Address - Phone:787-445-2984
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 171 KM 0.9 BO SUD
Practice Address - Street 2:SECTOR LOS VALLES
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00730-0550
Practice Address - Country:US
Practice Address - Phone:787-445-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13354103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst